Kyle Phillip Dietrich, PASTUDENT
Kyle Phillip Dietrich, PASTUDENT is a Massage Therapist in Pocatello, Idaho. Licensed in Montana. Registered with an NPI since 2019.
- Licensed in
- MT
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
921 S 8th Ave Stop 8253Pocatello, ID 83209-0002
Phone: (208) 282-4726
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|---|
| Massage Therapist | Taxonomy 225700000X · Licence LMT-LMT-LIC-15881 (MT) |
Record details
| NPI number | 1932661352 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PASTUDENT |
| Sole proprietor | No |
| NPI enumerated | April 3, 2019 |
| Last updated in NPPES | May 5, 2024 |
| Certification date | May 5, 2024 |
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Evelyn Galloway, LICENSED
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